Impact of financial support on treatment outcomes of multidrug-resistant tuberculosis: A population-based, retrospective cohort study in Shanghai, China

Abstract

Background

To date, the prolonged treatment duration and expensive second-line anti-tuberculosis drugs (SLDs) for multidrug-resistant tuberculosis (MDR-TB) can impose a significant financial burden, which may negatively impact treatment outcomes. This study examines the effect of a subsidy policy on treatment outcomes of MDR-TB patient..

Methods

We collected demographic and drug resistance data of all registered MDR-TB patients between April 2011 and December 2019 in Shanghai, China. Documentation of financial support received was routinely maintained until December 2021. We employed multivariate logistic regression to assess the association between financial support and treatment outcomes, estimating odds ratios (ORs) and their corresponding 95% confidence intervals (CIs).

Results

Of the 865 patients, 70.6% (611/865) achieved treatment success. The median amount compensated under the subsidy policy was 2359 United States dollar (USD), with an interquartile range from 1116 to 5652 USD. A positive association was found between benefiting from the subsidy policy and higher rate of treatment success, with an adjusted OR of 2.95 (95% CI, 2.03–4.28). Among the 641 patients covered by the policy, the adjusted OR comparing those with higher versus lower reimbursement was 1.74 (95% CI, 1.16–2.61).

Conclusions

Financial support policies for MDR-TB patients demonstrate a positive influence on treatment outcomes.